Active NPI
Injamamul Latif Niloy, DDS
- Oral and Maxillofacial Surgery (Dentist)
- Fort Belvoir, VA
National Provider Identifier
1851868129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 0401416341
- Practice address
- Oaks Pavillion, 1St Floor
RM. 01.319
Fort Belvoir, VA 22060 - Phone
- (571) 231-3519
- NPI assigned
- Oct 25, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 17905 | MD | |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 0401416341 | VA | Primary |
| General Practice Dentistry | 1223G0001X | 0401416341 | VA |
Addresses
Primary practice location
Oaks Pavillion, 1St Floor
RM. 01.319
Fort Belvoir, VA 22060
Mailing address
5802 Army Pentagon
Washington, DC 20310-5811
Phone (561) 727-4089
Other practice location 1
6564 Loisdale Ct Ste 110
Springfield, VA 22150-1822
Phone (703) 936-7671
Other practice location 2
10 Chatham Heights Rd
Fredericksburg, VA 22405-2566
Phone (540) 792-4223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230613001736 | VA | Order and Referring Only - Oral Surgery | 9638536287 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401416341 | VA | MD | Oral and Maxillofacial Surgery (Dentist) |
| 17905 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Springfield Orthodontic Associates, PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Preferred Provider Organization
- Springfield, VA
- NPI 1316162456
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730073600000",
"number": "1851868129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5802 ARMY PENTAGON",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "203105811",
"telephone_number": "561-727-4089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "OAKS PAVILLION, 1ST FLOOR",
"address_2": "RM. 01.319",
"city": "FORT BELVOIR",
"state": "VA",
"postal_code": "22060",
"telephone_number": "571-231-3519"
}
],
"practiceLocations": [
{
"address_1": "6564 Loisdale Ct Ste 110",
"address_purpose": "LOCATION",
"city": "Springfield",
"state": "VA",
"postal_code": "221501822",
"country_code": "US",
"telephone_number": "703-936-7671",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "10 Chatham Heights Rd",
"address_purpose": "LOCATION",
"city": "Fredericksburg",
"state": "VA",
"postal_code": "224052566",
"country_code": "US",
"telephone_number": "540-792-4223",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NILOY",
"first_name": "INJAMAMUL",
"middle_name": "LATIF",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-10-25",
"last_updated": "2024-10-28",
"certification_date": "2024-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "MD",
"license": "17905",
"primary": false
},
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "VA",
"license": "0401416341",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401416341",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Belvoir, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.